A Slow-Digesting, Low-Glycaemic Load (SD-LGL) Nutritional Beverage 1 improves glucose tolerance in obese pregnant women without Gestational 2 Diabetes

Background: Obesity is a risk factor for gestational diabetes. Low glycaemic 28 index diets attenuate hyperglycaemia. We designed a study to determine 29 whether a slow-digesting low-glycaemic load (SD-LGI) beverage improves 30 glucose tolerance in obese pregnant women without gestational diabetes 31 (GDM). This was a 3-arm comparison study comparing the effects of a SD- LGL nutritional beverage (glycaemic load [GL] 730), an isocaloric control beverage (GL 1124) and habitual diet on glycaemia in obese pregnant women. Sixteen women (mean BMI 37kg/m 2 ) were recruited at 24-28 weeks’ to receive either the SD-LGL or eucaloric control beverage. This was consumed with breakfast and as a mid-afternoon snack over 2 days with a 39 controlled diet. Following a 2-day washout period of habitual diet, women completed 2 days on the alternative beverage with controlled diet. A 10h fast 41 preceded each intervention phase. 24h glucose was measured using continuous glucose monitoring. Consumption of the lower glycaemic load beverage was associated with improved measures of glycaemia, compared to the control beverage and habitual diet at different time periods. Glucose estimates for control v SD-LGI at 24h (0.23mmol/l [0.16 to 0.31], p<0.001), daytime (0.26mmol/l [0.18 to 48 0.34], p<0.001) and time (0.05mmol/l to 0.11] Post-

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